Pediatric providers must have HIV-specific expertise to effectively manage the increasing complexity of HIV disease management for children. The literature suggests a positive correlation between the number of HIV+ (adult) patients seen by a provider and the quality of health care outcomes. It is therefore critical that pediatric HIV providers stay abreast of new antiretroviral (ARV) treatment regimens to treat pediatric patients based on state-of-the-art treatment guidelines.

All pediatric patients, birth to 13 years, should have a visit with a pediatric HIV specialist at least once every four months.

A pediatric HIV specialist is a provider experienced in direct ambulatory care of HIV-infected children. This experience is defined by the following criteria:

• Management of antiretroviral (ARV) therapy in at least 20 pediatric patients during the past year
• Ten or more hours annually of Continuing Medical Education (CME) activities that include information on the use of antiretroviral therapy in the ambulatory care setting 
• Pediatric practitioners can also be certified as HIV specialists based on policies endorsed by major medical associations, medical societies, or local government that have been adopted by the clinic.

Formula:  The number of pediatric patients (birth to 13 years) with at least one HIV primary care visit in the past 12 months, who also had at least one documented visitation with a pediatric HIV specialist during the last four months; divided by the total number of pediatric patients (birth to 13 years) with at least one HIV primary care visit in the last 12 months. Multiply by 100 to calculate percent.

For further explanation of this indicator and/or criteria for exclusions, please view indicator definitions produced by the National HIVQUAL Project.

100 percent of pediatric patients will have at least one visit with an HIV specialist every four months.

Assess all pediatric patients, birth to 13 years, monthly or at the frequency established by your quality improvement effort. Count the number of pediatric patients with at least one HIV primary care visit during the past 12 months who also had a documented visit with a pediatric HIV specialist during the past four months. Divide by the total number of pediatric patients, birth to 13 years, with at least one HIV primary care visit during the past 12 months. Multiply by 100 to calculate percent.

The National HIVQUAL Project’s Minimum Sample Table will help you determine the number of records to include in your sample. The Research Randomizer can generate a random number series to help you select which records to review.